I would like to ask your help. I am a guy, 25 years old, and have been dealing with cystic acne for 10 years. At first, I did things the traditional way - going to a derm and getting massive amounts of doxycycline, antibiotic cream, etc, but my acne became progressively worse. It was only after I stopped all antibiotics/prescription meds 5 years ago did I experience some relief in regards to my skin. I still use BP on my skin but nothing else, and even this I am questioning now.

Although there was some improvement to my cystic acne years ago, I am puzzled about my current predicament. I am now constantly dealing with lip acne, pimples that may or may not come to a head dotted around my bottom lip mostly. They come in bunches and sometimes scar badly. Then they go away for a few weeks or a month, and then come right back. I have grown a beard, and for some reason my upper lip where my mustache is rarely gets acne anymore, and I don’t use any topicals on it....interesting huh? Same thing with forehead, I never put a topical on it and to this day I never had a pimple on it.

Now to my nose. I have been told I have rosacea and I have been told its just acne by different derms. I frequently get very large, deep, painful whiteheads 5 or so at a time, smack dab in the center of my nose. They make my nose beet red and leave deep scars. Then they go away for a few weeks or a month and finally when my nose is almost healed.....they come right back and its two weeks of Rudolph nose and scabs. On top of that I get marble and golf ball sized cysts on my neck frequently that are quite painful, i'd almost rather deal with these though because when I have nose and lip acne I feel so embarrassed I don't even want to look at my girlfriend.

I am done with the status quo dermatology field, they have done nothing for me except destroy my gut and inflame my acne. After reading “The Clear Skin Diet” and alternative health articles by respected MDs, I am convinced acne is from within and much to do with diet/lifestyle. So 5 months ago I cut back on dairy, cheese, white starches, while increasing my fiber, and switched my toothpaste to natural and no longer use chapstick. Still, the acne persists. I admit, there is room for improvement. I still smoke. I still slip here and eat a cheeseburger once and a while but I am trying harder then ever. I also have been dealing with anxiety for quite a while but I do a lot of deep breathing/relaxation techniques, etc.

Any help or advice as to why I get the acne where I do on my face and neck? What am I doing wrong or what do you think I should do about it? Is change in order, should I ditch all the BP for good? Thank you so much for your time and help.

Or if your acne is very bad and persistent i would suggest you go on accutane. Maybe a low dose.

I never considered accutane ever, but it seems like diet helps 80% of my acne, but its still persistant, so im going on a low dose accutane dosage to clear the other 20% up for good.

I eat a lot of:

Brown Rice, Beef, Chicken,Tuna,Tilapia, broccoli, carrots, string beans, lentils, kale, whole wheat pasta and drink OJ, but other than that I must say I do not eat much fruit. I also "cheat" and end up eating a burrito or greasy chinese food a few times a week, although I used to eat that type of stuff almost daily so this is a major improvement and change for me. I also drink alcohol daily in moderation. I try to stay away from preservatives, GMOs and fast food, but I am not there 100% yet. I am trying though, but god its hard to change my diet since I really got used to getting take out and eating junk all the time.

I really limited dairy, to the point where I might have cheese once a month at most and no milk except for a splash in my tea. I do tend to over do it on protein, I like to eat a lot of it.

I also am guilty of: not exercising enough lately, and not going out and getting fresh air. I think I had kind of a "F-it" moment recently where I just stopped caring because for a while there I was exercising, eating really well, etc and I still got flare ups so I let myself go a bit, but I realized i'm much better of taking care of my body either way so I stepped my game up and am now back on the wagon really trying to limit certain foods, exercise more, etc.

I don't think rosacea causes whiteheads. I don't think there's ever any pus involved. It can form large nodules that can disfigure your nose and flat red splotches and overall redness on your cheeks and nose.

I think that cysts tend to be a food intolerance. And other kinds of ane that occur in the same place over and over. I would follow a methodical elimination diet. Either follow a very hypoallergenic diet for about a month during which you'll hopefully see an improvement then gradually add foods one by one or in groups of related foods. Or start methodically removing things from your diet starting with the most commonly problematic foods like wheat/gluten, dairy, eggs, peanuts, true nuts, shellfish, citrus, night shades, etc.

Is your skin oily? Do you have other allergies? Digestive problems? The lip problem could be follicular us.

Status: Clear after 30 years. Wow, I guess it's been 6 years, now.

[ Story: Severe Acne since I was 10. 10+ years of Dermatologists, Antibiotics, topicals and ACCUTANE did nothing. Discovered oranges triggered the worst of my cystic acne = about 70% improvement. Tried some nutrient supplements like B-complex with zinc and C, saw palmetto and a BHA like the aspirin mask = more improvement, a lot less oily. Then, Diet changes = Clear.

Regimen: Anti-inflammatory, nutrient dense, blood sugar stabilizing diet and supplements (for hormones, inflammation, aging, health). No soap or other cleanser except for hand washing! Water only or Oil cleanse. Aloe Vera mixed with niacinimide and a high linoleic acid oil for moisturizer and reduce pigmentation.

I don't think rosacea causes whiteheads. I don't think there's ever any pus involved. It can form large nodules that can disfigure your nose and flat red splotches and overall redness on your cheeks and nose.

I think that cysts tend to be a food intolerance. And other kinds of ane that occur in the same place over and over. I would follow a methodical elimination diet. Either follow a very hypoallergenic diet for about a month during which you'll hopefully see an improvement then gradually add foods one by one or in groups of related foods. Or start methodically removing things from your diet starting with the most commonly problematic foods like wheat/gluten, dairy, eggs, peanuts, true nuts, shellfish, citrus, night shades, etc.

Is your skin oily? Do you have other allergies? Digestive problems? The lip problem could be follicular us.

I am no expert, but have done a bit of research and from what I read there is a form of rosacea where acne and rosacea kind of go hand in hand, don't know if this is what I have but I thought i'd throw it out there.

I have suffered from digestive problems since going off of antibiotics. Mind you I was on doxycycline with antibiotic cream for three or four years, every day. The nurse practioners at my derms office kept refilling it and telling me to take it, no one ever even said "let's do rounds of this and stop so you have time to readjust", no one told me to take probiotics. I was just a naive 18 year old kid at the time, I knew nothing about the dangers of antibiotics and I trusted all my doctors. They just kept feeding me the doxycylcine. I almost think this is grounds for a lawsuit because I believe doctors are supposed to take you off and do rounds of antibiotics.....but thats another story,

I have frequent stomach aches, although adding fiber has helped tremendously. I must also add, and this is very important: for the last year I have been battling constant fungal skin infections of my feet and groin. I have read that antibiotic use can result in candida overgrowth which can contribute to or cause acne/fungal infections. I'm skeptical about taking probiotic supplements, but I am willing to try to eat probiotic foods. Is yogurt or kefir alright? I know it's dairy, but still....I can't stand sourkraut and I don't know what other foods I can eat that have probiotics. I get acne anyway now even without the milk.

When you say my lip acne can be "follicular us" what do you mean by that?

Oh, I also have a combination of dry skin on my face and an oily nose.

If I were you, I would stop using BP. But do it gradually so as not to shock your skin. BP made my skin worse and aggravated my acne. I would recommend finding a gentle cleanser and rinse with clean water, preferably deionized (tap water can be harsh on skin). Let your skin calm down for a while and avoid aggressive treatments.

I don't think rosacea causes whiteheads. I don't think there's ever any pus involved. It can form large nodules that can disfigure your nose and flat red splotches and overall redness on your cheeks and nose.

I think that cysts tend to be a food intolerance. And other kinds of ane that occur in the same place over and over. I would follow a methodical elimination diet. Either follow a very hypoallergenic diet for about a month during which you'll hopefully see an improvement then gradually add foods one by one or in groups of related foods. Or start methodically removing things from your diet starting with the most commonly problematic foods like wheat/gluten, dairy, eggs, peanuts, true nuts, shellfish, citrus, night shades, etc.

Is your skin oily? Do you have other allergies? Digestive problems? The lip problem could be follicular us.

I am no expert, but have done a bit of research and from what I read there is a form of rosacea where acne and rosacea kind of go hand in hand, don't know if this is what I have but I thought i'd throw it out there.

I have suffered from digestive problems since going off of antibiotics. Mind you I was on doxycycline with antibiotic cream for three or four years, every day. The nurse practioners at my derms office kept refilling it and telling me to take it, no one ever even said "let's do rounds of this and stop so you have time to readjust", no one told me to take probiotics. I was just a naive 18 year old kid at the time, I knew nothing about the dangers of antibiotics and I trusted all my doctors. They just kept feeding me the doxycylcine. I almost think this is grounds for a lawsuit because I believe doctors are supposed to take you off and do rounds of antibiotics.....but thats another story,

I have frequent stomach aches, although adding fiber has helped tremendously. I must also add, and this is very important: for the last year I have been battling constant fungal skin infections of my feet and groin. I have read that antibiotic use can result in candida overgrowth which can contribute to or cause acne/fungal infections. I'm skeptical about taking probiotic supplements, but I am willing to try to eat probiotic foods. Is yogurt or kefir alright? I know it's dairy, but still....I can't stand sourkraut and I don't know what other foods I can eat that have probiotics. I get acne anyway now even without the milk.

When you say my lip acne can be "follicular us" what do you mean by that?

Oh, I also have a combination of dry skin on my face and an oily nose.

I meant folliculitus. I was using my ipad and must not have noticed the spelling 'correction.'

I'm not sure what you mean by rosacea and acne going hand in hand. You can have both. I do. And others here do as well. But I don't think the white heads on your nose are rosacea. Also, the same diet changes and habits that cleared my acne keeps my rosacea under control. And before that, I discovered that not applying harsh acne products and using aloe vera topically did more for my rosacea than the creams the dermatologist prescribed.

And you need to address your digestion problems or you probably won't see improvement. Try adding some healing foods like bone broths and mucilagenous plant foods like okra, aloe vera and prickly pear cactus, purslane, chia seed, etc. And it depends on your particular intolerance to dairy, if you have one, whether you can have yogurt or kefir. A lot of the problematic things in cow dairy are reduced during fermentation such as the IgF1 and lactose. Making it yourself with organic milk, or getting goat, coconut or some other form besides cow dairy would be best. When you make it yourself you can add a probiotic capsule to get a variety of strains of beneficial flora. Also easy to make yourself is fermented vegetables. It doesn't have to be saurkraut. There's a fermented carrots and ginger recipe in the food and recipe thread.

The cysts I used to get on my neck turned out to be a reaction to most citrus, btw.

Status: Clear after 30 years. Wow, I guess it's been 6 years, now.

[ Story: Severe Acne since I was 10. 10+ years of Dermatologists, Antibiotics, topicals and ACCUTANE did nothing. Discovered oranges triggered the worst of my cystic acne = about 70% improvement. Tried some nutrient supplements like B-complex with zinc and C, saw palmetto and a BHA like the aspirin mask = more improvement, a lot less oily. Then, Diet changes = Clear.

Regimen: Anti-inflammatory, nutrient dense, blood sugar stabilizing diet and supplements (for hormones, inflammation, aging, health). No soap or other cleanser except for hand washing! Water only or Oil cleanse. Aloe Vera mixed with niacinimide and a high linoleic acid oil for moisturizer and reduce pigmentation.

Thank you so much for all your advice, I will certainly add more of those foods to my diet.

I have decided to begin a low dairy, anti-inflammatory diet (low gi foods, no white breads at all, etc), and if my acne worsens then I will cut out all dairy, then yeast, then gluten, etc until I am clear. I need to be consistent which I have not been doing.

One more thing, I have been using a 10% BP face wash which seems to help sometimes, other times its useless and I have horrible flare ups. I just bought some sulfur cream by a company called De La Cruz and I was thinking that this might be a better alternative. one poster here said I should quit the BP entirely. But if I am going on a diet and also stopping BP and switching to something else at the same time, how will I know which one broke me out? Any advice?

Have you ever considered that it might be a hormonal issue? Guys can have hormonal imbalances too.

Besides being male, my story is very similar to yours, and I had acne like you described. Huge painful cysts on my neck and back, smaller problems around mouth/nose area, and clear on my forehead. No rosacea though. I am also 25 and had acne since puberty. No extreme diet changes, topicals, accutane, antibiotics, etc helped me. The only thing that has made a real change is treating it hormonally.

Have you ever considered that it might be a hormonal issue? Guys can have hormonal imbalances too.

Besides being male, my story is very similar to yours, and I had acne like you described. Huge painful cysts on my neck and back, smaller problems around mouth/nose area, and clear on my forehead. No rosacea though. I am also 25 and had acne since puberty. No extreme diet changes, topicals, accutane, antibiotics, etc helped me. The only thing that has made a real change is treating it hormonally.

Just a thought.

I have actually, and I think you may be onto something. However, hormonal imbalances are something I am a bit unfamiliar with. How do I find out if I have one , and, what are some ways I could correct it without taking any prescription medications?

Oh and I have actually decided to stop the BP and switch to a daily sulfer treatment called De La Cruz sulfer ointment. Any thoughts on this?